Queer blood

Controversy over the prohibition on blood donations from gay men surfaces after the terrorist attacks.

THE DAY OF THE terrorist attacks, people around the country lined up to offer the very substance of their bodies: They gave blood. In the Puget Sound area alone, 2,500 people showed up at blood centers, a one-day record.

Brian Judd says blood policy stigmatizes gay men.

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Yet one large group of Americans was not allowed to participate: gay men. Guidelines from the U.S. Food and Drug Administration prohibit blood donations from any man who's had sex with another man—"even once"—since 1977 (when the HIV virus first began to spread).

"I was very frustrated," says Brian Judd, a 23-year-old researcher at a Seattle nonprofit, who happened to visit the bloodmobile near his workplace just a few weeks before the terrorist attacks. When he responded "yes" to the screening question about sex with a man, he was politely turned away, and his name and social security number were marked in the blood bank computer system as a "permanent deferral."

Judd maintains he is HIV negative, has been vaccinated for hepatitis A and B, has no sexually transmitted diseases, and has had only one sexual partner, who "holds the same health profile." In a letter last month to the head of the Puget Sound Blood Center, he wrote that the blood policy "perpetuates the stigma that [gay men] constantly face: that we all take part in risky behavior, void of any regard for infection and disease."

Michael Taylor, a 26-year-old Capitol Hill resident, describes the policy as "shameful" and "blatant discrimination." Last week, he too sent off a letter to the Blood Center and the FDA, angered that "my community and I cannot contribute in this way." Taylor says he used to give blood regularly back in college—"before I ran afoul of their little question." Now Taylor, who says he's practicing safe sex in a committed, monogamous relationship, wonders, "Is there no way to assess risk factors without specifying sex or orientation? Is there no provision for assessing if someone actually engages in high-risk behavior?"

The Blood Center's spokesperson, Keith Warnack, says the blanket prohibition is needed as a safeguard. He says that every unit of donated blood is tested for 10 different disease markers, including antibodies that would indicate the presence of HIV. But, he says, "the tests are not 100 percent effective. The reason the guidelines are so strict is because the tests aren't perfect."

And the current system seems to be working. Since 1985, when the test for HIV antibodies was first introduced, there hasn't been a single instance of anyone in Western Washington contracting AIDS through a blood transfusion, according to Warnack. Prior to that, he says, approximately 40 blood recipients got exposed.

MEN WHO HAVE had sex with men are not the only ones barred, of course. People who have recently traveled in countries where malaria is prevalent are not supposed to give, nor are people who've spent six months or more, cumulatively, in the U.K. between 1980 through 1996 (so as to combat the possibility of transmitting the human version of mad cow disease). Warnack says the blood center turns away roughly 15 percent of the people who come through its doors. "We know many of those people are probably in perfectly good health," he says.

But the prohibition on gay blood donors is perhaps the most controversial piece of blood bank policy, and has been repeatedly reviewed and revisited by the FDA. As recently as a year ago, a 15-member advisory committee decided, by a margin of one vote, not to relax the standard.

One committee member who voted with the minority is Kathi Knowles, executive director of the Health Information Network in Seattle. Says Knowles: "As long as it continues to be in the news that [HIV] infection among gay men is on the rise, the policy is not likely to change."

A spokesperson for the FDA declined to speak on the record about the subject or to make anyone at the agency available for an interview. But on its Web site the agency says it "believes there is scientific justification for screening out all [men who have sex with men]." The agency says federal studies have shown that "many people who believe they are engaging in safe sex practices are not doing so, either because of poor technique or lack of consistency." The FDA says it "is very much aware that [its] strict exclusion policies eliminate some safe donors in the attempt to maximally protect the nation's blood supply."

For now, it seems, the nation can easily afford the prohibition. Blood centers are flush. And Warnack says that with its regular year-round drives, the Puget Sound center is usually able to maintain the three-day, 3,000-unit inventory that it considers safe. No Puget Sound blood donations have been required for the terrorist victims in New York or Washington. Gruesomely enough, it was human skin for all the burn victims that was really in short supply.